Provider Demographics
NPI:1922265024
Name:HORN, CRAIG A (PHD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:A
Last Name:HORN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 GREENLAND DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3018
Mailing Address - Country:US
Mailing Address - Phone:864-271-5066
Mailing Address - Fax:
Practice Address - Street 1:45 GREENLAND DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3018
Practice Address - Country:US
Practice Address - Phone:864-271-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC430103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical